Risk of Osteoporosis Associated with Glucocorticoid Use in Pemphigus Vulgaris: Insights from a Retrospective Cohort Study

Introduction: Pemphigus vulgaris (PV) is an autoimmune bullous disease affecting the skin and mucous membranes. Osteoporosis, a significant side effect of commonly used glucocorticoids in treatment, can adversely contribute to the existing morbidity. Objectives: This study aims to assess the impa...

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Main Authors: Merve Kaya, Gülhan Aksoy Saraç, Onur Acar, Selma Emre, Akın Aktaş
Format: Article
Language:English
Published: Mattioli1885 2025-04-01
Series:Dermatology Practical & Conceptual
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Online Access:https://dpcj.org/index.php/dpc/article/view/5050
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author Merve Kaya
Gülhan Aksoy Saraç
Onur Acar
Selma Emre
Akın Aktaş
author_facet Merve Kaya
Gülhan Aksoy Saraç
Onur Acar
Selma Emre
Akın Aktaş
author_sort Merve Kaya
collection DOAJ
description Introduction: Pemphigus vulgaris (PV) is an autoimmune bullous disease affecting the skin and mucous membranes. Osteoporosis, a significant side effect of commonly used glucocorticoids in treatment, can adversely contribute to the existing morbidity. Objectives: This study aims to assess the impact of glucocorticoid therapy on bone mineral density in patients with PV. Methods: Patients newly diagnosed with PV were included in this study. Femur and lumbar T-scores, serum calcium, vitamin D, alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) levels were analyzed before and 1 year after therapy. Results: Among 66 patients, the average time to diagnosis was 10.14 months, and the average daily dose of prednisone was 16.95 mg, with 63.6% of patients receiving medium doses. Our data showed no significant change in lumbar T-scores after one year of glucocorticoid treatment, but a significant decrease in femur density was observed. The decrease in femur T-scores was significant in the medium-dose group, while the lumbar T-scores decreased significantly in the high-dose group. There was no significant correlation between T-scores and gender, menopausal state, diagnosis time, or obesity. Additionally, vitamin D and LDH levels significantly increased after treatment, while changes in serum calcium and ALP levels were not significant. Conclusion: Given the multiple factors that reduce bone mineral density in PV patients, the current strategies for glucocorticoid-induced osteoporosis prophylaxis in this group may need re-evaluation, with potential for additional recommendations to be included in pemphigus guidelines.
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spelling doaj-art-efd253ca5ee34aec8b2ff27548889df82025-08-20T01:48:24ZengMattioli1885Dermatology Practical & Conceptual2160-93812025-04-0115210.5826/dpc.1502a5050Risk of Osteoporosis Associated with Glucocorticoid Use in Pemphigus Vulgaris: Insights from a Retrospective Cohort StudyMerve Kaya0Gülhan Aksoy Saraç1Onur Acar2Selma Emre3Akın Aktaş4Department of Dermatology, Bilkent City Hospital, Ankara, TurkeyDepartment of Dermatology, Bilkent City Hospital, Ankara, TurkeyOrhangazi District Health Directorate, Bursa, TurkeyDepartment of Dermatology, Ankara Yıldırım Beyazıt University, Medical School, Ankara, TurkeyDepartment of Dermatology, Ankara Yıldırım Beyazıt University, Medical School, Ankara, Turkey Introduction: Pemphigus vulgaris (PV) is an autoimmune bullous disease affecting the skin and mucous membranes. Osteoporosis, a significant side effect of commonly used glucocorticoids in treatment, can adversely contribute to the existing morbidity. Objectives: This study aims to assess the impact of glucocorticoid therapy on bone mineral density in patients with PV. Methods: Patients newly diagnosed with PV were included in this study. Femur and lumbar T-scores, serum calcium, vitamin D, alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) levels were analyzed before and 1 year after therapy. Results: Among 66 patients, the average time to diagnosis was 10.14 months, and the average daily dose of prednisone was 16.95 mg, with 63.6% of patients receiving medium doses. Our data showed no significant change in lumbar T-scores after one year of glucocorticoid treatment, but a significant decrease in femur density was observed. The decrease in femur T-scores was significant in the medium-dose group, while the lumbar T-scores decreased significantly in the high-dose group. There was no significant correlation between T-scores and gender, menopausal state, diagnosis time, or obesity. Additionally, vitamin D and LDH levels significantly increased after treatment, while changes in serum calcium and ALP levels were not significant. Conclusion: Given the multiple factors that reduce bone mineral density in PV patients, the current strategies for glucocorticoid-induced osteoporosis prophylaxis in this group may need re-evaluation, with potential for additional recommendations to be included in pemphigus guidelines. https://dpcj.org/index.php/dpc/article/view/5050pemphigus vulgarisosteoporosisbone mineral density
spellingShingle Merve Kaya
Gülhan Aksoy Saraç
Onur Acar
Selma Emre
Akın Aktaş
Risk of Osteoporosis Associated with Glucocorticoid Use in Pemphigus Vulgaris: Insights from a Retrospective Cohort Study
Dermatology Practical & Conceptual
pemphigus vulgaris
osteoporosis
bone mineral density
title Risk of Osteoporosis Associated with Glucocorticoid Use in Pemphigus Vulgaris: Insights from a Retrospective Cohort Study
title_full Risk of Osteoporosis Associated with Glucocorticoid Use in Pemphigus Vulgaris: Insights from a Retrospective Cohort Study
title_fullStr Risk of Osteoporosis Associated with Glucocorticoid Use in Pemphigus Vulgaris: Insights from a Retrospective Cohort Study
title_full_unstemmed Risk of Osteoporosis Associated with Glucocorticoid Use in Pemphigus Vulgaris: Insights from a Retrospective Cohort Study
title_short Risk of Osteoporosis Associated with Glucocorticoid Use in Pemphigus Vulgaris: Insights from a Retrospective Cohort Study
title_sort risk of osteoporosis associated with glucocorticoid use in pemphigus vulgaris insights from a retrospective cohort study
topic pemphigus vulgaris
osteoporosis
bone mineral density
url https://dpcj.org/index.php/dpc/article/view/5050
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